Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,862.09 / $7,943.28	Facility		$1,148.15	$1,862.09	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,548.82 / $2,089.30	Professional		$933.25	$1,548.82	$2,089.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,148.15 / $2,041.74	Facility		$645.65	$1,148.15	$2,041.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,548.82 / $1,698.24	Facility		$1,122.02	$1,548.82	$1,698.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,202.26 / $1,862.09	Facility		$776.25	$1,202.26	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,888.44 / $7,244.36	Facility		$4,570.88	$5,888.44	$7,244.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,754.40 / $8,912.51	Facility		$1,698.24	$5,754.40	$8,912.51